RE-OPERATIVE SURGERY FOR RECURRENT PRIMARY HYPERPARATHYROIDISM ASSOCIATED WITH OLIGOMENORRHEA

Ana Valea1,2, V. Muntean1,2, Andra Morar2, Mara Carsote 4,5, Cristina Căpăţână4,5, Simona Elena Albu 4,6

1The University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania
2The Department of Endocrinology, The Clinical County Hospital, Cluj-Napoca, Romania
3The CFR Hospital, Cluj-Napoca, Romania
4The University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
5The National Institute of Endocrinology “C. I. Parhon” Bucharesti, Romania
6The University Emergency Hospital, Bucharest, Romania

Corresponding author: Maria Carsote
Phone no. 0040213172041
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Abstract

Recurrent primary hyperparathyroidism is characterized by typical symptoms and biochemical recurrence of hypercalcemia after more than 6 months of normal calcium levels after surgery. We report the case of a 39-year-old female patient presenting with menses disturbances who was diagnosed with primary hyperparathyroidism caused by a left inferior parathyroid adenoma at the age of 35. Postoperative 6-month follow-up showed normalization of biochemical and hormonal profiles, with significant improvement of clinical symptoms, dominated by muscle weakness, weight loss and oligomenorrhea. The 18-month follow-up showed elevated PTH and serum calcium levels. Imaging confirmed recurrence of primary hyperparathyroidism by highlighting a right upper parathyroid adenoma. Surgery was performed again and no major incident was seen. The particularity of this case consists in the recurrence of primary hyperparathyroidism in a young patient with no family history of the disease due to asynchronous parathyroid adenomas that were successfully removed in a female patient who in addition to classic complications such as calyceal microlithiasis and osteoporosis presented oligomenorrhea which was resolved spontaneously after the correction of hypercalcemia.

 

Keywords: parathyroidectomy, recurrent hyperparathyroidism, hypercalcemia, oligomenorrhea

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